The research of risk factors of intraoperative complications occurring during phacoemulsification on eyes with primary open angle glaucoma at normalized IOP

Poster Details

First Author: E.Sorokin RUSSIA

Co Author(s):    N. Postupaeva   A. Egorova   A. Postupaev        

Abstract Details

Purpose:

The combination of cataract and primary open angle glaucoma (POAG) can be found in 17-76% according to different data, and it increases up to 40-85% at exfoliative glaucoma. It is known that glaucomatous eye has a number of peculiarities which play unfavorable role at performing phaco surgery. The purpose of the work is to evaluate the initial status of eyes of patients who suffer from POAG with normalized IOP and cataract in terms of perspectives of optimal phaco surgery in this group of patients.

Setting:

Khabarovsk branch of the academician S.N. Fyodorov Federal State Institution" Intersectorial Research and Technology Complex " Eye Microsurgery" .

Methods:

We examined preoperative condition of 52 eyes (52 patients) with complicated cataract against the background POAG with normal IOP level. The age of patients varied from 59 to 81 years; there were 30 women and 22 men. 12 eyes had initial stage of cataract, premature cataract was found in 33 eyes, mature – in 7 eyes. Initial stage of glaucoma process was found in 7 eyes, developed – 25 eyes, and far gone in 20 eyes. IOP varied from 16 to 23 mm Hg. 35 patients previously underwent antiglaucoma surgery. 34 patients had moderate hypotensive regimen.

Results:

39 eyes had different signs of pseudoexfoliative syndrome (PES) – exfoliate deposition on the anterior capsule of lens, iris and in the angle of the anterior chamber; dystrophic changes of anterior capsule of lens and iris. There were vast posterior pigment synechias (the consequence of previously performed antiglaucoma surgery). We revealed the weakness of zonule of Zinn of different degree in 36 cases. Besides lens subluxation of 1st degree was found in 14 eyes (it was proved using ultrasound biomicroscopy). The maximal medicamentous mydriasis made 3-4 mm in 27 eyes, 5-6 mm in 28 eyes. The maximal level of mydriasis (7-8 mm) was not achieved in any case.

Conclusions:

1. 82% of examined eyes had the whole range of factors which can complicate phaco surgery 2. Phacoemulsification on glaucomatous eyes shall be performed using additional technical manipulations – making iridotomy, synechiotomy, applying of iris- retractors, implantation of intracapsular ring, the selection of sparing irrigation-aspiration parameters, and also a more delicate manipulation in the anterior chamber while performing surgery. FINANCIAL DISCLOSURE?: No